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Butterworth To Present Gorgas Lecture, Oct. 10

By Jennifer Wenger

The evolution of biomedical research in Africa — from an ongoing emphasis on parasitic illnesses to an intensified focus on the prevailing scourges of tuberculosis (TB) and HIV/AIDS — will be the topic of discussion when Dr. Anthony Butterworth, a leading authority on tropical disease in sub-Saharan Africa, presents the 10th Gorgas Memorial Leon Jacobs lecture, sponsored by NIAID. The lecture, titled "The Changing Face of Biomedical Research in Africa: A Personal Perspective," will be held at 3 p.m. Friday, Oct. 10, in Wilson Hall, Bldg. 1.

A British citizen and self-described "Africaphile," Butterworth has conducted research, both in the laboratory and the field, in Kenya, Senegal, South Africa, Sudan, Uganda, and Zimbabwe, in addition to the Philippines, South America and the United States. He has dedicated most of his 30-year career to the study of schistosomiasis, a devastating parasitic illness that affects roughly 200 million people in developing countries worldwide. The disease is caused by a blood fluke that lives part of its life in certain types of snails and, in its larval form, penetrates the skin of people who wade, swim or bathe in the contaminated water the snails inhabit. Depending on the species of parasite, it can cause both acute illness and, more importantly, chronic, long-term damage to the liver or urinary tract, which may lead to death.

Dr. Anthony Butterworth
Butterworth's research into the epidemiology and control of schistosomiasis as well as the human body's immune responses to the parasite have advanced understanding of the mechanisms of disease in general, while bringing the world closer to a safe and effective vaccine. When asked about his most noteworthy accomplishments in this arena, however, he is quick to point to the contributions of his peers.

"Scientific discovery is a slow-moving, methodical accumulation of events, like the tide coming in," he said. "At most, you may cause a 'ripple,' but you couldn't generate a ripple if it weren't for the tide."

One of Butterworth's more sizable ripples occurred in the mid-1970s when he served as a research fellow at the Wellcome Trust Research Laboratories in Nairobi. There, he and others demonstrated that eosinophils, granule-containing white blood cells known to be involved in allergic reactions such as asthma, can kill the larval form of the schistosome parasite when working in concert with certain antibodies.

"Up until that point, eosinophils were merely thought of as nasty, but that didn't make sense from an evolutionary standpoint," he said. Later, as a research fellow at Harvard Medical School, he and several colleagues demonstrated that eosinophils destroy the schistosome by releasing highly toxic granules onto the larva's surface.

Butterworth's next ripple came when, as an external scientific staff member of Britain's Medical Research Council, he and a team of researchers demonstrated that humans can develop immunity to schistosomiasis over time. In longitudinal studies conducted in Kenya and Uganda, they showed that, beginning at approximately 12 years of age, individuals experience an increase in levels of IgE antibodies — another key culprit in allergic reactions — that react against antigens of the adult parasite, as well as a drop in levels of certain antibodies that obstruct the immune response. Molecules recognized by the IgE antibodies in immune humans are being investigated as possible candidates for a vaccine.

Butterworth says that although work toward a vaccine continues, less emphasis is now being placed on this goal for two reasons: drugs for treating schistosomiasis today are less toxic and costly and more effective than they were 30 years ago, and there is little economic incentive for drug companies to manufacture a vaccine. Instead, researchers are now more interested in the mechanisms by which the infection progresses to chronic disease or death in some individuals.

"Lots of people are infected, but only some get sick," said Butterworth. "Was the patient malnourished? Did he have malaria? HIV? It's the interaction between schistosomiasis and such conditions that is most interesting to researchers," he said. "We can no longer look at schistosomiasis in isolation."

In his current role as honorary scientific director of the Biomedical Research and Training Institute, Harare, Zimbabwe, Butterworth helps oversee research conducted in such areas as malaria, TB and HIV/AIDS. He and his wife, Dr. Liz Corbett, have studied the interaction between HIV and TB in gold miners in South Africa and are now investigating the relationship in factory workers in Zimbabwe. The risk of developing TB is much greater for individuals infected with HIV/AIDS, with TB being the leading cause of death for HIV patients worldwide.

Butterworth received his education at the University of Cambridge (B.A., 1966; M.B., B.Chir., 1969; M.A., 1970; Ph.D., 1973). He was elected a fellow of the Royal Society, London, in 1994, and is a member of the Royal Society of Tropical Medicine and Hygiene. Among his awards are the Chalmers Medal from the Royal Society of Tropical Medicine (1990), the King Faisal International Prize in Medicine from the King Faisal Foundation (1990), and the Bernhard Nocht Medal from the Bernhard Nocht Institute (1987).

The Gorgas Lecture is sponsored by NIAID's Laboratory of Parasitic Diseases. For more information, contact Cynthia Nishikawa Fabry at 496-5717.

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